Getting to Know Your Reporting Options for 2017 PURDUE HEALTHCARE ADVISORS

ELIGIBILITY

TO MIPS OR NOT TO MIPS? Who will participate in MIPS? Who will NOT participate in MIPS? Clinicians in their first year of Medicare Part B participation Clinicians below the low patient volume threshold Clinicians participating in Advanced APMs that are Qualified Participants (QP) MIPS does not apply to hospitals/facilities or providers that do not bill Medicare Part B 2019+ 2017-2018 Physicians (MD/DO & DMD/DDS) Physician Assistants Nurse Practitioners Clinical Nurse Specialists Certified Nurse Anesthetists Physicians (MD/DO & DMD/DDS) Physician Assistants Nurse Practitioners Clinical Nurse Specialists Certified Nurse Anesthetists Physical Therapists Occupational Therapists Speech/Language Pathologists Audiologists Nurse Midwives Clinical Social Workers Clinical Psychologists Dietitians & Nutritional Professionals This is a choose your own adventure story, but the adventure is kind of already chosen for you – at least for the first few years…. Since the majority of providers will fall into the MIPS category at first, we’re focusing mostly on this right now.

LOW VOLUME THRESHOLD Clinicians can be excluded from MIPS participation based on Part B claims volume or Medicare Part B beneficiary volume OR LVT Determination Periods for 2017: September 1, 2015 to August 31, 2016 and September 1, 2016 to August 31, 2017 < $30,000 Medicare Part B Allowable Charges < 100 Medicare Part B Beneficiaries

PICK YOUR PACE

MIPS Performance Year 2017 ONLY “PICK YOUR PACE” MIPS Performance Year 2017 ONLY 2017 is designated as a transitional year Eligible Clinicians (ECs) participating in MIPS will have multiple options Choosing one of these participation options and fulfilling the necessary requirements ensures you do not receive a negative payment adjustment in 2019

MIPS Performance Year 2017 ONLY “PICK YOUR PACE” MIPS Performance Year 2017 ONLY Don’t Participate Don’t send in any 2017 data  receive a -4% payment adjustment in 2019 OPTION 1: “Test” the QPP Submit minimum amount of data in 2017  receive no adjustment OPTION 2: Partial Participation Submit 90 days of 2017 data  receive neutral or small positive payment adjustment in 2019 OPTION 3: Full Participation Submit full year of 2017 data  receive moderate positive payment adjustment in 2019

First Option: Test the QPP “PICK YOUR PACE” First Option: Test the QPP Submit one of the following to QPP: 1 quality measure 5 required ACI objectives 1 IA Minimum 90 day reporting period Avoid negative payment adjustment This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more.

Second Option: Partial Participation “PICK YOUR PACE” Second Option: Partial Participation Submit a partial set of data to the QPP 1-5 Quality measures 5 required ACI objectives 1 or more CPIA Minimum 90 day reporting period You can start submitting on a date after 1/1/17 Must start by October 2, 2017 Small positive payment adjustment possible Avoid the negative payment adjustment

Third Option: Full Participation “PICK YOUR PACE” Third Option: Full Participation Participate in QPP for the full* calendar year beginning on 1/1/17 and submit all required data 6 Quality Measures or 1 Measures Set 5 required ACI objectives Report additional measures for performance score IA- up to four activities Possible modest positive payment adjustment Avoid the negative payment adjustment * Does not need to be exactly 365-days, but the longer the reporting period, the higher the potential incentive

Fourth Option: Participate in Advanced APM “PICK YOUR PACE” Fourth Option: Participate in Advanced APM Join an AAPM (track 2 or 3) Receive 5% lump sum bonus in 2019

SUMMARY: PICK YOUR PACE OPTIONS

REPORTING METHODS

REPORTING METHODOLOGY Quality* Cost Advancing Care Information Improvement Activities Year 1 Weighting No Weighting Individuals QCDR Qualified Registry EHR Administrative Claims (no submission required) Claims Administrative Claims (no submission required) Attestation Groups CMS Web Interface** (Groups of 25+) CAHPS for MIPS Survey *Reporting must cover a minimum of 50% of Medicare Part B beneficiaries **Groups reporting Web Interface must register by June 30, 2017

Get Ready for 2017 Pick Your Pace!! Make sure your Certified EHR Technology is MIPS ready Consider using a qualified clinical data registry or a registry to extract and submit your quality data. Review quality metrics to prepare for measure selection

MIPS & MEDICAID MU PROGRAM Don’t Forget! MIPS does not change the requirements under the Medicaid EHR Incentive Program!! If you are participating in Medicaid MU: You must still comply with the established requirements under that program And also have Medicare Part B claims, then you will report to BOTH programs

Presenter Allison Bryan-Jungels MS, CHES Senior Advisor, GLPTN Quality Lead and IN Program Manager (765) 496-9791 abryan@purdue.edu www.pha.purdue.edu